Stanford Medicine clinical leadership is focused on improving the value of the health care that we provide for our patients. This means reliably providing evidence-based care (see Population Health, previous post); and equally important is not providing unnecessary care, which by definition wastes precious health care resources and often also has a net negative clinical  impact on our patients.

On March 23, SHC implemented an Epic module that creates alerts for a small number of orders that don’t meet the Choosing Wisely guidelines. Choosing Wisely is a set of recommendations organized by the ABIM. Most of these suggestions are designed to reduce the use of unnecessary tests and treatments. For more information about the program, I’ve attached a description of Choosing Wisely and SHC’s Epic implementation at the bottom of this blog post; click the link above for additional information, including materials designed for patients to assist us in explaining the recommendation.

These Choosing Wisely alerts are intended to help educate providers who may be ordering care that they may not realize is not evidence based, or more often to remind busy providers that they may be mistakenly ordering care that they, on reflection, would agree that they already know is unnecessary. Of course there will also be alerts that fire mistakenly because the reason for the order is not recognized by Epic – or you may have other perfectly good reasons to order the care. In either case, it’s easy to bypass the alert by simply documenting the reason for the care.

We anticipate that most providers will receive a small number (<10) alerts per month during this initial phase. If you are receiving excessive alerts or find that this program is significantly interfering with your care, or if you have additional questions or concerns, please let me know. Additional information is available here. 

About Choosing Wisely
SHC Choosing Wisely-Epic Implementation